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Mucocutaneous disease and related clinical characteristics in hospitalized children and adolescents with COVID-19 and multisystem inflammatory syndrome in children

BACKGROUND: Little is known about mucocutaneous disease in acutely ill children and adolescents with COVID-19 and multisystem inflammatory syndrome in children (MIS-C). OBJECTIVE: To characterize mucocutaneous disease and its relation to clinical course among hospitalized patients with COVID-19 and...

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Detalles Bibliográficos
Autores principales: Rekhtman, Sergey, Tannenbaum, Rachel, Strunk, Andrew, Birabaharan, Morgan, Wright, Shari, Garg, Amit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the American Academy of Dermatology, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585496/
https://www.ncbi.nlm.nih.gov/pubmed/33323343
http://dx.doi.org/10.1016/j.jaad.2020.10.060
Descripción
Sumario:BACKGROUND: Little is known about mucocutaneous disease in acutely ill children and adolescents with COVID-19 and multisystem inflammatory syndrome in children (MIS-C). OBJECTIVE: To characterize mucocutaneous disease and its relation to clinical course among hospitalized patients with COVID-19 and MIS-C. METHODS: Descriptive cohort study of prospectively and consecutively hospitalized eligible patients between May 11, 2020 and June 5, 2020. RESULTS: In COVID-19 patients, 4 of 12 (33%) had rash and/or mucositis, including erythema, morbilliform pattern, and lip mucositis. In MIS-C patients, 9 of 19 (47%) had rash and/or mucositis, including erythema, morbilliform, retiform purpura, targetoid and urticarial patterns, along with acral edema, lip mucositis, tongue papillitis, and conjunctivitis. COVID-19 patients with rash had less frequent respiratory symptoms, pediatric intensive care unit admission, invasive ventilation, and shorter stay versus COVID-19 patients without rash. MIS-C patients with rash had less frequent pediatric intensive care unit admission, shock, ventilation, as well as lower levels of C-reactive protein, ferritin, D-dimer, and troponin (vs MIS-C without rash). Neutrophil-to-lymphocyte ratio was similar for patients with and without rash in both groups. None of the MIS-C patients met criteria for Kawasaki disease. LIMITATIONS: Small sample sizes. CONCLUSIONS: Mucocutaneous disease is common among children and adolescents with COVID-19 and MIS-C. Laboratory trends observed in patients with rash may prognosticate a less severe course.